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Lower Serum Fetuin-A Levels are Associated with a Higher Ten-Year Mortality Risk in Patients with ST-Elevation
Hakan Çakır1, Selçuk Kanat2, Hilal Çakır3
1Kartal Kosuyolu Training and Research Hospital , Istanbul - Turquia.
Insights
Low levels of fetuin-A (a protein) are linked to worse long-term outcomes and higher mortality in patients with ST-elevation acute myocardial infarction (STEMI). This finding highlights fetuin-A as a key prognostic marker in cardiovascular disease.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Fetuin-A is an established anti-inflammatory and anti-calcification factor.
- Its role as a cardiovascular risk marker in coronary artery disease (CAD) is under investigation, but its prognostic significance remains debated.
Purpose of the Study:
- To investigate the association between serum fetuin-A levels and long-term cardiovascular disease (CVD) and all-cause mortality in patients with ST-elevation acute myocardial infarction (STEMI).
Main Methods:
- 180 consecutive STEMI patients were enrolled.
- Patients were stratified into lower (≤288 µg/ml) and higher (>288 µg/ml) fetuin-A groups based on the median level.
- Clinical outcomes were assessed via annual telephone follow-up for a median of 10 years, with mortality causes confirmed by national databases.
Main Results:
- Over a median 10-year follow-up, 71 deaths occurred, 62 from CVD.
- The lower fetuin-A group exhibited significantly higher CVD (44% vs 24%) and all-cause mortality (48% vs 31%) compared to the higher fetuin-A group.
- Fetuin-A independently predicted both CVD and all-cause mortality in Cox regression analyses.
Conclusions:
- Low serum fetuin-A concentrations indicate a poor long-term prognosis following STEMI.
- This association holds true irrespective of traditional cardiovascular risk factors.
- The findings reinforce the critical role of anti-inflammatory mediators in acute coronary syndromes.
Background:
Fetuin-A is an anti-inflammatory and anti-calcification factor involved in the course of coronary artery disease (CAD). In line with these functions, fetuin-A has been investigated as a cardiovascular risk marker in many studies. However, the association between fetuin-A and the prognosis of CAD patients is still controversial.
Objectives:
The present study was conducted to identify the association between serum fetuin-A level and long-term cardiovascular disease (CVD) and all-cause mortality of ST-elevation acute myocardial infarction (STEMI).
Methods:
One hundred eigthy consecutive patients with STEMI were enrolled in the study. The study population was divided into subgroups (lower, ≤288 µg/ml; and higher, >288 µg/ml) according to the median fetuin-A level. Clinical follow-up data was obtained by annual contact with the patients or family members by telephone. The causes of death were also confirmed by the national health database. Two-sided p-values<0.05 were considered statistically significant.
Results:
During a median follow-up of 10 years, 71 deaths were recorded , 62 of whom died from CVD. Both CVD and all-cause mortality were found to be significantly higher in the lower fetuin-A group than the higher fetuin-A group (44% vs 24%, p= 0.005; 48% vs 31%, p= 0.022, respectively). In Cox regression proportional hazard analyses, fetuin-A was found to be an independent predictor of CVD and all-cause mortality.
Conclusions:
Low fetuin-A concentration is associated with a poor long-term prognosis after STEMI, regardless of the traditional cardiovascular risk factors. Our findings have strengthened previous studies that consistently demonstrate the determining role of anti-inflammatory mediators in acute coronary syndromes.
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